Suzuki Yasuhiro, Tokuda Yutaka, Saito Yuki, Ohta Masatoshi, Tajima Tomoo
Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Jpn J Clin Oncol. 2003 Oct;33(10):514-7. doi: 10.1093/jjco/hyg101.
Since the clinical introduction of trastuzumab (Herceptin) for metastatic breast cancers that overexpress human epidermal growth factor receptor 2 (HER2), this anticancer agent has played an important role in breast cancer treatment. We examined the effects of trastuzumab and vinorelbine (Navelbine) as a second- or third-line therapy in 24 patients whose HER2-positive tumors did not respond to or relapsed after administration of trastuzumab alone or in combination with taxane.
Trastuzumab was administered at 2 mg/kg (loading dose 4 mg/kg) once weekly and vinorelbine at 25 mg/m(2) once weekly. The median treatment duration was 118.5 days (range, 22-351 days).
The response rate was 42% (95% confidence interval (CI): 22%-63%). The adverse events of NCI-CTC grade 3 or above consisted of neutropenia in three patients; other adverse events, including vasculitis, generalized fatigue, anemia and thrombocytopenia, were grade 1 or 2. All adverse events were reversible after treatment withdrawal and were easily manageable.
A combination of trastuzumab and vinorelbine can be safely administered on an outpatient basis, and is useful in the treatment of patients with HER2-overexpressing metastatic breast cancer.
自曲妥珠单抗(赫赛汀)临床应用于过表达人表皮生长因子受体2(HER2)的转移性乳腺癌以来,这种抗癌药物在乳腺癌治疗中发挥了重要作用。我们研究了曲妥珠单抗和长春瑞滨(诺维本)作为二线或三线治疗方案对24例HER2阳性肿瘤在单独使用曲妥珠单抗或与紫杉烷联合使用后无反应或复发的患者的疗效。
曲妥珠单抗以2mg/kg(负荷剂量4mg/kg)每周给药一次,长春瑞滨以25mg/m²每周给药一次。中位治疗持续时间为118.5天(范围22 - 351天)。
缓解率为42%(95%置信区间(CI):22% - 63%)。美国国立癌症研究所常见毒性标准(NCI - CTC)3级或以上的不良事件包括3例患者出现中性粒细胞减少;其他不良事件,包括血管炎、全身疲劳、贫血和血小板减少,均为1级或2级。所有不良事件在停药后均可逆转,且易于处理。
曲妥珠单抗和长春瑞滨联合用药可在门诊安全给药,对HER2过表达的转移性乳腺癌患者的治疗有效。